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Inaugural Meeting of the Strategic and Technical Advisory Group on Disease Elimination (Virtual Meeting) Meeting Report and Recommendations 14-15 October 2020 Inaugural Meeting of the Strategic and Technical Advisory Group on Disease Elimination, 14–15 October 2020. Meeting Report and Recommendations PAHO/CDE/HT/21-0009 © Pan American Health Organization, 2021 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO license (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this license, this work may be copied, redistributed, and adapted for non-commercial purposes, provided the new work is issued using the same or equivalent Creative Commons license and it is appropriately cited. In any use of this work, there should be no suggestion that the Pan American Health Organization (PAHO) endorses any specific organization, product, or service. Use of the PAHO logo is not permitted. All reasonable precautions have been taken by PAHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall PAHO be liable for damages arising from its use. Contents Introduction ................................................................................................................................................... 2 1. Objectives .............................................................................................................................................. 2 2. Methodology and participants.............................................................................................................. 2 3. Positioning PAHO’s disease elimination initiative in the evolving context of COVID-19 ..................... 3 4. Promotion and operationalization of integrated health service delivery for disease elimination ...... 6 5. Conclusions and Recommendations ..................................................................................................... 7 APENDIX ....................................................................................................................................................... 13 Appendix 1. Members of STAG on Disease Elimination .............................................................................. 13 Appendix 2. List of participants ................................................................................................................... 14 Appendix 3. Background Document 1: Setting the Scene – The PAHO Disease Elimination Initiative and the Evolving Context of COVID-19 ............................................................................................................... 16 Appendix 4. Background document 2: Role and Importance of Operational Research in the context of the PAHO Disease Elimination Initiative ............................................................................................................ 22 Appendix 5. Milestones in the Elimination of Communicable Diseases in the Region of the Americas. 24 Appendix 6. Communicable diseases and related conditions candidates for elimination by 2030........ 25 Appendix 7. Agenda ................................................................................................................................. 26 Appendix 8. Group photo ................................................................................................................. 28 525 23rd St. NW, Washington, D.C., 20037 | +1 202-974-3453 | www.paho.org | 1 Introduction This report provides a summary of the proceedings, conclusions, and recommendations of the first meeting of the PAHO/WHO Strategic and Technical Advisory Group (STAG) on Disease Elimination. Throughout its history, the Pan American Health Organization (PAHO) has played a key role in supporting important disease elimination achievements in the Americas and globally. These achievements were made possible through the adoption of public health approaches that are spelled out in frameworks and sets of recommended disease-control interventions, providing for robust vaccination and mass drug administration programs for targeted neglected infectious diseases as well as, water and sanitation programs and housing quality and safety initiatives. To support the work ahead and reinforce PAHO`s leading role in the disease elimination efforts in the Americas, in October 2019 PAHO Member States endorsed the PAHO Disease Elimination Initiative and a Policy for an Integrated Sustainable Approach to Communicable Diseases in the Americas. The Elimination initiative provides a sustainable framework to orient and guide Member States towards elimination of a group of priority communicable diseases and related conditions. It envisions future generations free of the burden of a set of communicable diseases in the Americas, beginning no later than 2030. 1. Objectives - Provide advice on strategic interventions to enhance PAHO technical cooperation and accelerate regional response towards disease elimination. - Facilitate discussions regarding evolving issues and priorities for disease elimination in the Region, particularly amidst the evolving context of the COVID-19 pandemic and other potential future disruptions. 2. Methodology and participants A two-day virtual meeting was held on 14-15 October 2020 with the appointed members of the STAG and delegates of PAHO. A list of the STAG members is given in Appendix 1, while the list of participants is provided in Appendix 2. After introducing participants, presenting the terms of reference of the STAG (available at https://www.paho.org/en/destination-elimination), and appointing the Chair (Patricia Garcia) and Co- Chair (Patrick Lammie), members of the STAG discussed and provided recommendations to PAHO on the following two strategic questions: 525 23rd St. NW, Washington, D.C., 20037 | +1 202-974-3453 | www.paho.org | 2 - How can we strategically position the Disease Elimination Initiative (politically, financially, and technically) under and within the evolving context of COVID- 19? - How do we promote and operationalize integrated health service delivery towards disease elimination (especially at the primary healthcare level)? Members of the STAG discussed the available documents of PAHO’s disease elimination initiative (1,2) and two background papers, one for each of the strategic questions, prepared by PAHO’s Secretariat (Appendixes 3 and 4). A debriefing session was held on 15 October by the Chair, Co-Chair, some other members of the STAG, and PAHO delegates with Dr. Carissa Etienne, Director of PAHO, to present the recommendations. A detailed agenda of the meeting is available in Appendix 5 and a group photo in Appendix 6. 3. Positioning PAHO’s disease elimination initiative in the evolving context of COVID-19 After reviewing the background of PAHO’s disease elimination initiative, the steps taken and progress upon its approval by PAHO’s Directing Council in October 2019 (3), and discussing challenges including the evolving context of COVID-19 in the Region of the Americas, the following relevant issues were identified by members of the STAG as priorities for PAHO and countries to position the disease elimination initiative. • PAHO’s disease elimination initiative is relevant to protect the achievements toward disease control and elimination in the Region of the Americas and to accelerate efforts to overcome the challenges imposed by COVID-19 through the framework of health as a human right. Lessons learned from the pandemic, especially those in which community actions contributed to reinforce community-centered approaches, integrated delivery of health services, reinforcement of information systems, among others, should be used to strengthen national and local health capacities towards Universal Health. • PAHO can be catalytic in advocating and creating regional networks of partners, institutions, organizations, including community-based organizations, to reinforce the regional capacities to reach the disease elimination goals. It is important to improve the work on integration and primary health care, aiming at the quality of services and the elimination of diseases. The regional networks should include different levels within country governments, private sector, communities, and media, and should promote and sustain communities of practice. • Reinforcement of local frameworks adapted to local needs and contexts should be promoted by PAHO including key components of resilient health systems such as local empowerment, leadership and 525 23rd St. NW, Washington, D.C., 20037 | +1 202-974-3453 | www.paho.org | 3 governance, information systems, health workforce, access to essential medicines, delivery of services, and financing. Documenting investment cases for diseases elimination is an important advocacy tool to show the benefits of the initiative and the role played in strengthening health systems. • Health systems should reinforce the interaction between human, animal and environmental health, through the One Health framework, providing communities with the tools and conditions to monitor, prevent and early response to epidemic of zoonotic and/or vector borne diseases. • PAHO can help countries to identify priorities in the current pandemic context, starting with those diseases showing increased morbidity and mortality due

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